Background: Solitary fibrous tumor of the pleura are rare neoplasms, and follow-up protocol is lacking. Various risk stratification systems have been proposed to predict recurrence. The aim of this study is to evaluate common risk scores and risk factors leading to a recommendation for follow-up frequency. Methods: We pooled data as part of a multicenter international study with the participation of eight centers in Germany, Switzerland, Denmark, and Austria. Kaplan–Meier survival-curves were used comparing several risk stratification system(s). A Log-rank test was performed to analyze prognostic clinical and pathological factors affecting overall and recurrence-free survival. Results: We included 155 patients from 2004 to 2024: 52.3% were male, median age was 64 years (range 32 to 89). Recurrence rate was 17.4% with median recurrence-free survival of 131 months. Mean time to recurrence was 64.4 (range 9–151) months. Analysis showed that age, tumor morphology, necrosis, and increased mitotic activity were independent prognostic factors for RFS. Conclusions: The WHO risk stratification system demonstrated the highest discriminatory power for recurrence-free survival in the Kaplan–Meier analyses, indicating that the WHO classification remains the most accurate predictor to date. We modified the commonly used risk systems to achieve improved stratification into low-, intermediate- and high-risk groups. The occurrence of late recurrences underscores the need for long-term follow-up.
背景：胸膜孤立性纤维瘤是一种罕见肿瘤，目前缺乏标准随访方案。已有多种风险分层系统被提出用于预测复发。本研究旨在评估常用风险评分及危险因素，以提出随访频率建议。 方法：我们整合了德国、瑞士、丹麦和奥地利八个中心参与的国际多中心研究数据。采用Kaplan-Meier生存曲线比较多种风险分层系统，并通过Log-rank检验分析影响总生存期和无复发生存期的临床与病理预后因素。 结果：研究纳入2004年至2024年155例患者，其中男性占52.3%，中位年龄64岁（范围32-89岁）。复发率为17.4%，中位无复发生存期为131个月，平均复发时间为64.4个月（范围9-151个月）。分析显示年龄、肿瘤形态、坏死及核分裂象增多是无复发生存期的独立预后因素。 结论：Kaplan-Meier分析表明WHO风险分层系统对无复发生存期具有最佳区分能力，提示WHO分类仍是目前最准确的预测指标。我们改良了常用风险系统，实现了低危、中危和高危分层的优化。晚期复发的发生凸显了长期随访的必要性。
肿瘤(癌症)患者之家